What every woman must know about health-care reform

From better pregnancy coverage to being unfettered by preexisting conditions, how the new bill affects you

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Our foul-mouthed VP is right: Health care reform is a big flipping deal. That much is clear. But, like most women, what I’m really wondering is how health care reform will impact me. So, like any good scientist, I polled my female Facebook friends to find out what they want to know. Then I tossed the Qs to SELF’s resident health insurance guru: news & health features director Sara Austin. Here’s her take:

What’s your gut: Is this law good or bad for women?It’s scandalous that a law to widen access to health care will result in a rollback of private insurance coverage for abortion, so that’s unequivocally bad news and a blow to women’s reproductive health. But overall, after years of covering the mess that is our health care system, I am excited about health care reform’s potential to improve and even save lives. SELF has told the stories of many women who have lost their insurance because they got sick or lost a job, who have had to skip care because they weren’t covered or who were bankrupted by a cancer diagnosis. If reform works as planned, there will be a lot fewer women forced into these horrible situations.

We know it’s good for Obama’s policy report card, but what happens next for us readers of SELF?A few things you can expect to see happen, pronto :

1. If you have kids, insurance companies won’t be allowed to deny them coverage for a preexisting condition.

2. If you’re under 26, you can hop on Mom and Dad’s health care plan—great if you’re a recent college grad who’s tempted to go without coverage or get high-deductible, catastrophic coverage that discourages you from seeing the doctor unless it’s a dire emergency.

3. If you are sans insurance at the moment due to a preexisting condition, in the next few months you may be able to get temporary coverage from a national high-risk pool.

And in the next few years…1. Your health history won’t be held against you. As SELF has reported, insurers now call almost anything a preexisting condition and charge you more for it: allergies, a C-section, irregular periods, even being a victim of domestic violence! Worst of all, being a woman itself has become a preexisting condition, in that insurers regularly charge women more for the same or inferior coverage. This blatantly discriminatory practice will be mostly (but not entirely) banned under the new law. Also, there will no longer be lifetime caps on coverage, which is great for people with chronic or serious illnesses, which could be any of us one day.

2. Better coverage if you get preggers. Coverage for maternity care has long been subpar, with many individual plans refusing to cover pregnancy or forcing women to buy expensive bonus coverage (called a “rider”) on top of their standard plan. Health care reform promises wider prenatal and maternity coverage under both private insurance and Medicaid. The law even requires companies to give nursing moms break time and a private place to pump milk for up to year. No more locking yourself in the supply closet!

3. Going uninsured will cost you. Most citizens and legal residents of the United States who can afford health insurance will be required to have it by 2014. If you don’t get insurance through your employer, each state will set up a marketplace called an exchange, where you can buy affordable individual coverage. Right now insurers charge individuals and small businesses much more, because big businesses have the power to negotiate rates down. Shockingly, hospitals also charge the uninsured more for the same care, too.

If after all these changes you still choose to go without coverage, you’ll pay a penalty. But hey, if you’re reading SELF, I know you care about your health and well-being, and that means insurance is not optional. Think of it like a bike helmet or a condom: Probably not your favorite thing to deal with, but the consequences of going without are just too scary. Check out CoverTheUninsured.org for more info on sorting out your options.

Wait, I like my current plan! Am I going to have to change it?Nope. If you have insurance through your employer, little should change. However, if you have one of those el cheapo catastrophic individual plans, things might change for you because insurance companies may offer fewer “junk” plans like this. Thing is, if you have one of these, you are probably looking to upgrade, so you could end up with better insurance and possibly some help to pay for it.

Will I have to pay more or less for my prescriptions? While some Medicare patients will see lower drug costs, the bill shouldn’t affect the cost of your meds—birth control included.

With so many more people receiving coverage, won’t it be hard to get an appointment with my doctor? This is a good question and a real concern. Is the system ready to treat the 32 million new customers who were previously uninsured and skipping health care? Primary-care doctors are in short supply in this country, because doctors can earn better pay for shorter hours and deal with less insurance paperwork in a specialty like plastic surgery, dermatology or radiology.

Congress has added new incentives for med students to go into primary care. Emergency rooms predict they will have less crowding as fewer uninsured patients show up at their doors. And the law also expands funding for community clinics, which are great for handling simple concerns like colds and flu.

Ultimately, I don’t see how it can be a bad thing for millions of people to get health care they weren’t getting before. And if you can’t get in to see your doctor, let her know—perhaps she could add a nurse-practitioner to her staff to see people with minor ailments. Like the rest of us, docs will have to adapt as reform goes from theory to reality.

How can the average woman use health care reform to improve her health?Here are three quickies:

• Chain restaurants will soon be required to list the calories in the food they sell. Eateries already do this in New York City, where SELF is based. It makes it so much easier to order smart! The 750-calorie taco salad? Thanks, but we’ll pass.

• Easy access to preventive care. Health reform will eliminate your copays and deductibles for smart screenings like mammograms and Pap smears, so there’s even less excuse to skip ‘em.

• For the first time in your life, you will know what your health care really costs. Hospitals will have to post prices and insurance companies will list standardized policies, so you can comparison shop. Payments from drug companies to doctors will be in a public database, too. This law puts a lot of new power into the hands of the people who use the health care system—i.e., you.

OK, this health care reform business seems pretty good for women, so what’s the catch? If you make more than $200,000 for a singleton or $250,000 for a couple, your taxes will go up to help cover the costs of these reforms. And if you’re an indoor tanning fanatic, you may see the cost go up because the bill includes a new tax on the service. But given that tanning beds are in the same cancer-risk category as cigarettes, you weren’t going to go there anyway, right?

Also, if you own a small business, your costs of providing insurance to your workers could change. There are also plenty of tax credits and special exchanges for small businesses, too. There’s a cool calculator that will tell you how the law affects your personal bottom line, based on your current salary and insurance status.

I don’t have a crystal ball that tells me exactly how this 2,000-page law will pan out. Without a doubt it will have some negative consequences and leave some patients behind. It’s up to us to keep pushing for a saner, fairer health care system—so speak up if something doesn’t seem right. Visit this site to contact your congressional rep directly.